Hyperglycaemia and Its Risk Factors Among Adults Living With HIV on Follow-Up at the Hawassa City Administration, Southern Ethiopia: A Cross-Sectional Study

Abstract

Background: Ethiopia implemented the universal test and treat in 2017 and later adopted dolutegravir-based regimens for people living with HIV (PLWH). However, the impact of these changes on glucose metabolism in Ethiopia remains unclear, highlighting the need for further investigation. Methods: A cross-sectional study was conducted in southern Ethiopia from 5 January 2023 to 30 May 2024. We included 443 adult PLWH using systematic random sampling. American Diabetes Association criteria was used to define hyperglycaemia. To identify factors associated with hyperglycaemia, binary logistic regression was used with adjusted odds ratio (AOR) and 95% confidence interval (CI). Results: Overall prevalence of hyperglycaemia was 24.4% (16.7% prediabetes and 7.7% diabetes mellitus [DM]). Of the participants with DM, 82.3% were newly diagnosed. Significant predictors of hyperglycaemia were age > 50 years (AOR 2.1; 95% CI 1.1–3.9), alcohol intake (AOR 2.1; 95% CI 1.02–4.2), obesity (AOR 3.2; 95% CI 1.3–7.9), high waist–hip ratio (AOR 2.6; 95% CI 1.4–5.05) and LDL-cholesterol (AOR 2.2; 95% CI 1.02–4.6). While significant predictors of DM were alcohol intake (AOR 3.0; 95% CI 1.1–8.4), co-morbidity (AOR 2.6; 95% CI 1.1–6.05), high waist circumference (AOR 7.5; 95% CI 1.3–43.3), high waist–hip ratio (AOR 4.1; 95% CI 1.02–16.2) and high triglycerides (AOR 3.2; 95% CI 1.3–7.7). Dolutegravir-based regimen was not associated with hyperglycaemia. Conclusion: Hyperglycaemia prevalence among adult PLWH on antiretroviral therapy in southern Ethiopia is rising, with most diabetes cases newly identified. This emphasises the critical need for routine screening to enable early detection, prevention and management.